Socioeconomic and Ethnic Differences in Disease Burden and Disparities in Physical Function in Older Adults

Abstract

Objectives. We investigated whether a greater burden of disease among poorer individuals and ethnic minorities accounted for socioeconomic and racial disparities in self-reported physical functioning among older adults. Methods. We used data from adults aged 60 years or older (n = 5556) in the Third National Health and Nutrition Examination Survey, 1988–1994 to test associations between education level, poverty index, and race/ethnicity and limitations in 11 functions. We adjusted for demographic features and measures of disease burden (comorbid conditions, smoking, hemoglobin level, serum albumin level, knee pain, body mass index, and skeletal muscle index). Results. Associations between education and functional limitations were attenuated after adjustment, but those with 0–8 years of education were more likely than those with 13 or more years of education to have limitations in 3 functions. Poverty was associated with a higher likelihood of limitations despite adjustment. The likelihood of limitations among non-Hispanic Blacks and Mexican Americans was similar to that of non-Hispanic Whites after adjustment. Conclusions. Socioeconomic disparities in functional limitations among older Americans exist independent of disease burden, whereas socioeconomic differences and disease burden account for racial disparities.

Associação entre cor/raça, obesidade e diabetes em idosos da comunidade: dados do Estudo FIBRA

“…Racial differences associated with higher morbity 19,46,47 , obesity 9,15,22,29 and disability 16,28 are largely explained by unfavorable socioeconomic conditions, with lead to an accumulation of unhealthy behaviors and lifestyle, due to lower access to information, quality education and health services. According to Chor 20 , race, socioeconomic status and gender are crucial variables Table 4 Effect of race on body fat among diabetic elderly individuals according to gender, adjusted by schooling and family income.…”

“…Socioeconomic disparities in obesity, as with other health conditions, are well-established in the literature 12,13,14,15,16 . Race and ethnicity, demographic characteristics which are also widely correlated with socioeconomic status 17,18,19,20 , are associated with obesity, evaluated by anthropometric indicators of general (BMI) 7,9,21,22,23 and central fat (waist circumference -WC and waist-hip ratio -WHR) 9,24,25 .…”

The Health of the Nation’s Custodial Grandfathers and Older Single Fathers: Findings From the Behavior Risk Factor Surveillance System

“…Smoking behaviors is most worrisome for the one fifth of older single fathers who reported that their grandchildren/ children have asthma. Lifestyle choices about smoking and other health behaviors are especially important to study with male-headed families from low-SES backgrounds because research has suggested that adverse health outcomes are more prevalent in these families (Harvey & Ogden, 2014;Louie & Ward, 2011;Sheffer et al, 2012). Improving access to smoking cessation programs and targeted messaging that emphasize the hazards of passive smoke to children is warranted (Pisinger, Hammer-Helmich, Andreasen, Jorgensen, & Glumer, 2012).…”

Household and neighborhood conditions partially account for associations between education and physical capacity in the National Health and Aging Trends Study

“…One pathway is by enhancing an individual’s ability to prevent and control chronic diseases. However, socioeconomic disparities in physical capacity are consistently found after accounting for health behaviors and presence of chronic diseases, suggesting additional pathways (Coppin et al, 2006; Lantz et al, 2001; Louie & Ward, 2011; Thorpe et al, 2011; Zaninotto et al, 2013). …”